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1.
BMC Public Health ; 20(1): 1475, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993606

RESUMO

BACKGROUND: In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan's disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. METHODS: We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan's National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017-2040, we modelled the three diseases using the data for 1990-2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. RESULTS: In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. CONCLUSIONS: The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs.


Assuntos
Doença Crônica/tendências , Pessoas com Deficiência/estatística & dados numéricos , Promoção da Saúde/organização & administração , Anos de Vida Ajustados por Qualidade de Vida , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Doenças Cardiovasculares/epidemiologia , Dieta/estatística & dados numéricos , Previsões , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco , Cloreto de Sódio na Dieta/administração & dosagem
2.
PLoS One ; 15(7): e0235514, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645031

RESUMO

INTRODUCTION: Cardiovascular diseases (CVDs) represent the main cause of death among non-communicable diseases (NCDs) in Brazil, and they have a high economic impact on health systems. Most populations around the world, including Brazilians, consume excessive sodium, which increases blood pressure and the risk of CVDs. OBJECTIVE: To model the estimated deaths and costs associated with CVDs, which are mediated by increased blood pressure attributable to excessive sodium consumption in adults from the perspective of the Brazilian public health system in 2017. METHODS: We employed two macrosimulation methods, using top-down approaches and based on the same relative risks. The models estimated the mortality and costs-of-illness attributable to excessive sodium intake and mediated by hypertension for adults aged over 30 years in 2017. Direct healthcare cost data (inpatient care, outpatient care and medications) were extracted from the Ministry of Health information systems and official records. RESULTS: In 2017, an estimated 46,651 deaths from CVDs could have been prevented if the average sodium consumption had been reduced to 2 g/day in Brazil. Premature deaths related to excessive sodium consumption caused 575,172 Years of Life Lost and US$ 752.7 million in productivity losses to the economy. In the same year, the National Health System's costs of hospitalizations, outpatient care and medication for hypertension attributable to excessive sodium consumption totaled US$192.1 million. The main causes of death and costs associated with CVDs were coronary heart disease and stroke, followed by hypertensive disease, heart failure and aortic aneurysm. CONCLUSION: Excessive sodium consumption is estimated to account for 15% of deaths by CVDs and to 14% of the inpatient and outpatient costs associated with CVD. It also has high societal costs in terms of premature deaths. CVDs are a leading cause of disease and economic burden on the global, regional and country levels. As a largely preventable and treatable conditions, CVDs require the strengthening of cost-effective policies, supported by evidence, including modeling studies, to reduce the costs relating to illness borne by the Brazilian public health system and society.


Assuntos
Efeitos Psicossociais da Doença , Cardiopatias/epidemiologia , Modelos Teóricos , Recomendações Nutricionais , Cloreto de Sódio na Dieta/efeitos adversos , Brasil , Feminino , Fidelidade a Diretrizes , Cardiopatias/economia , Cardiopatias/etiologia , Cardiopatias/mortalidade , Humanos , Masculino , Cloreto de Sódio na Dieta/normas , Organização Mundial da Saúde
3.
Curr Hypertens Rep ; 22(7): 45, 2020 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-32591971

RESUMO

PURPOSE OF REVIEW: Excessive dietary salt intake is associated with an increased risk of hypertension. Salt sensitivity, i.e., an elevation in blood pressure in response to high dietary salt intake, has been associated with a high risk of cardiovascular disease and mortality. We investigated whether a causal association exists between dietary sodium intake and hypertension risk using Mendelian randomization (MR). RECENT FINDINGS: We performed an MR study using data from a large genome-wide association study comprising 15,034 Korean adults in a community-based cohort study. A total of 1282 candidate single nucleotide polymorphisms associated with dietary sodium intake, such as rs2960306, rs4343, and rs1937671, were selected as instrumental variables. The inverse variance weighted method was used to assess the evidence for causality. Higher dietary sodium intake was associated with salt-sensitive hypertension risk. The variants of SLC8E1 rs2241543 and ADD1 rs16843589 were strongly associated with increased blood pressure. In the logistic regression model, after adjusting for age, gender, smoking, drinking, exercise, and body mass index, the GRK4 rs2960306TT genotype was inversely associated with hypertension risk (OR, 0.356; 95% CI, 0.236-0.476). However, the 2350GG genotype (ACE rs4343) exhibited a 2.11-fold increased hypertension risk (OR, 2.114; 95% CI, 2.004-2.224) relative to carriers of the 2350AA genotype, after adjusting for confounders. MR analysis revealed that the odds ratio for hypertension per 1 mg/day increment of dietary sodium intake was 2.24 in participants with the PRKG1 rs12414562 AA genotype. Our findings suggest that dietary sodium intake may be causally associated with hypertension risk.


Assuntos
Hipertensão , Sódio na Dieta , Adulto , Estudos de Coortes , Quinase 4 de Receptor Acoplado a Proteína G , Estudo de Associação Genômica Ampla , Humanos , Hipertensão/genética , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Cloreto de Sódio na Dieta/efeitos adversos , Sódio na Dieta/efeitos adversos
5.
Artigo em Inglês | MEDLINE | ID: mdl-32325839

RESUMO

Salt intake is too high for safety nowadays. The main active ion in salt is sodium. The vast majority of scientific evidence points out the importance of sodium restriction for decreasing cardiovascular risk. International Guidelines recommend a large reduction in sodium consumption to help reduce blood pressure, organ damage, and cardiovascular risk. Regulatory authorities across the globe suggest a general restriction of sodium intake to prevent cardiovascular diseases. In spite of this seemingly unanimous consensus, some researchers claim to have evidence of the unhealthy effects of a reduction of sodium intake, and have data to support their claims. Evidence is against dissenting scientists, because prospective, observational, and basic research studies indicate that sodium is the real villain: actual sodium consumption around the globe is far higher than the safe range. Sodium intake is directly related to increased blood pressure, and independently to the enlargement of cardiac mass, with a possible independent role in inducing left ventricular hypertrophy. This may represent the basis of myocardial ischemia, congestive heart failure, and cardiac mortality. Although debated, a high sodium intake may induce initial renal damage and progression in both hypertensive and normotensive subjects. Conversely, there is general agreement about the adverse role of sodium in cerebrovascular disease. These factors point to the possible main role of sodium intake in target organ damage and cardiovascular events including mortality. This review will endeavor to outline the existing evidence.


Assuntos
Hipertensão , Hipertrofia Ventricular Esquerda , Cloreto de Sódio na Dieta , Pressão Sanguínea , Transtornos Cerebrovasculares/etiologia , Humanos , Hipertensão/complicações , Estudos Prospectivos , Cloreto de Sódio na Dieta/efeitos adversos
6.
PLoS One ; 15(4): e0231707, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298354

RESUMO

BACKGROUND: A high salt diet is associated with the development of hypertension, one of the most important cardiovascular risk factors. A reduction in sodium intake seems to have an effect on increasing serum triglycerides (TGs). Elevated TGs are independently linked to cardiovascular risk. However, there is limited evidence of a possible interactive effect of sodium intake and serum TGs on high blood pressure (BP). METHODS: We conducted a nationwide, population-based interaction analysis using the Kawasaki method for estimating 24-h urinary sodium excretion (e24hUNaEKawasaki) as a candidate indicator of dietary sodium intake. All native Koreans aged 20 years or older without significant medical illness were eligible for inclusion. RESULTS: A total of 16936 participants were divided into quintiles according to their e24hUNaEKawasaki results. Participants in the highest quintile were more obese and hypertensive and had higher white blood cell count, lower hemoglobin, greater glycemic exposure, and poor lipid profiles compared to the same parameters of individuals in other quintiles. Linear regression revealed that e24UNaEKawasaki was related to systolic BP, diastolic BP, and TGs. Multiple logistic regression, adjusted for dietary sodium intake and various conventional risk factors for chronic vascular diseases, showed that both e24UNaEKawasaki and TGs were significant predictors of hypertension. Our interaction analysis demonstrated that increased sodium intake was associated with higher risk of hypertension in participants with elevated TGs than in those without (adjusted RERI = 0.022, 95% CI = 0.017-0.027; adjusted AP = 0.017, 95% CI = 0.006-0.028; adjusted SI = 1.010, 95% CI = 1.007-1.014). CONCLUSION: Our findings suggest that the interaction between a high salt diet and elevated TGs may exert synergistic biological effects on the risk of hypertension.


Assuntos
Hipertensão/etiologia , Cloreto de Sódio na Dieta/efeitos adversos , Triglicerídeos/sangue , Adulto , Feminino , Humanos , Hipertensão/sangue , Hipertrigliceridemia/sangue , Hipertrigliceridemia/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-32302491

RESUMO

Renovascular hypertension is characterized by activation of the renin-angiotensin-aldosterone system, blunted natriuretic responses, and elevated sympathetic nerve activity. Excess dietary salt intake exaggerates arterial blood pressure (ABP) in multiple models of experimental hypertension. The present study tested whether a high-salt diet exaggerated ABP and vascular dysfunction in a 2-kidney, 1-clip (2K1C) murine model. Male C57BL/6J mice (8-12 wk) were randomly assigned, and fed a 0.1% or 4.0% NaCl diet, and instrumented with telemetry units to measure ABP. Then, the 2K1C model was produced by placing a cuff around the right renal artery. Systolic, diastolic, and mean ABP were significantly higher in mice fed 4.0% vs. 0.1% NaCl at 1 wk but not after 3 wk. Interestingly, 2K1C hypertension progressively increased arterial pulse pressure in both groups; however, the magnitude was significantly greater in mice fed 4.0% vs. 0.1% NaCl at 3 wk. Moreover, pulse wave velocity was significantly greater in 2K1C mice fed 4.0% vs. 0.1% NaCl diet or sham-operated mice fed either diet. Histological assessment of aortas indicated no structural differences among groups. Finally, endothelium-dependent vasodilation was significantly and selectively attenuated in the aorta but not mesenteric arteries of 2K1C mice fed 4.0% NaCl vs. 0.1% NaCl or sham-operated control mice. The findings suggest that dietary salt loading transiently exaggerates 2K1C renovascular hypertension but promotes chronic aortic stiffness and selective aortic vascular dysfunction.NEW & NOTEWORTHY High dietary salt exaggerates hypertension in multiple experimental models. Here we demonstrate that a high-salt diet produces a greater increase in arterial blood pressure at 1 wk after induction of 2-kidney, 1-clip (2K1C) hypertension but not at 3 wk. Interestingly, 2K1C mice fed a high-salt diet displayed an exaggerated pulse pressure, elevated pulse wave velocity, and reduced endothelium-dependent vasodilation of the aorta but not mesenteric arteries. These findings suggest that dietary salt may interact with underlying cardiovascular disease to promote selective vascular dysfunction and aortic stiffness.


Assuntos
Hipertensão Renovascular/etiologia , Cloreto de Sódio na Dieta/efeitos adversos , Rigidez Vascular , Animais , Aorta/efeitos dos fármacos , Aorta/patologia , Aorta/fisiopatologia , Pressão Sanguínea , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/patologia , Endotélio Vascular/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Cloreto de Sódio na Dieta/toxicidade , Vasoconstrição
8.
PLoS One ; 15(3): e0229756, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32126132

RESUMO

The aim of this work was to study the effect of a high sodium (HS) diet on blood pressure and renal function in male adult rats that have been treated with a dual Endothelin receptor antagonist (ERA) during their early postnatal period (day 1 to 20 of life). Male Sprague-Dawley rats were divided in four groups: CNS: control rats with normosodic diet; ERANS: ERA-treated rats with normosodic diet; CHS: control rats with high sodium diet; ERAHS: ERA-treated rats with HS diet. Systolic blood pressure (SBP) was recorded before and after the diet and 24-hour metabolic cage studies were performed. AQP2 and α-ENac expressions were measured by western blot and real time PCR in the renal medulla. Vasopressin (AVP) pathway was evaluated by measuring V2 receptor and adenylyl cyclase 6 (AC6) expression and cAMP production in the renal medulla. Pre-pro ET-1mRNA was also evaluated in the renal medulla. Only rats that had been treated with an ERA during their postnatal period increased their SBP after consumption of a HS diet, showing an impaired capacity to excrete sodium and water, i.e. developing salt sensitivity. This salt sensitivity would be mediated by an increase in renomedullary expression and activity of AQP2 and α-ENaC as a consequence of increased AC6 expression and cAMP production and/or a decreased ET-1 production in the renal medulla. The knowledge of the molecular mechanisms underlying the perinatal programming of salt sensitive hypertension will allow the development of reprogramming strategies in order to avoid this pathology.


Assuntos
Endotelinas/metabolismo , Hipertensão/etiologia , Medula Renal/crescimento & desenvolvimento , Receptores de Endotelina/metabolismo , Transdução de Sinais/fisiologia , Adulto , Animais , Animais Recém-Nascidos , Aquaporina 2/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Modelos Animais de Doenças , Antagonistas dos Receptores de Endotelina/farmacologia , Endotelinas/antagonistas & inibidores , Canais Epiteliais de Sódio/metabolismo , Humanos , Hipertensão/fisiopatologia , Recém-Nascido , Medula Renal/efeitos dos fármacos , Masculino , Ratos , Ratos Sprague-Dawley , Eliminação Renal/efeitos dos fármacos , Eliminação Renal/fisiologia , Transdução de Sinais/efeitos dos fármacos , Cloreto de Sódio na Dieta/efeitos adversos , Cloreto de Sódio na Dieta/metabolismo , Vasopressinas/metabolismo
10.
Circ Res ; 126(7): 839-853, 2020 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-32078445

RESUMO

RATIONALE: High-salt diet is one of the most important risk factors for hypertension. Intestinal flora has been reported to be associated with high salt-induced hypertension (hSIH). However, the detailed roles of intestinal flora in hSIH pathogenesis have not yet been fully elucidated. OBJECTIVE: To reveal the roles and mechanisms of intestinal flora in hSIH development. METHODS AND RESULTS: The abovementioned issues were investigated using various techniques including 16S rRNA gene sequencing, untargeted metabolomics, selective bacterial culture, and fecal microbiota transplantation. We found that high-salt diet induced hypertension in Wistar rats. The fecal microbiota of healthy rats could dramatically lower blood pressure (BP) of hypertensive rats, whereas the fecal microbiota of hSIH rats had opposite effects. The composition, metabolism, and interrelationship of intestinal flora in hSIH rats were considerably reshaped, including the increased corticosterone level and reduced Bacteroides and arachidonic acid levels, which tightly correlated with BP. The serum corticosterone level was also significantly increased in rats with hSIH. Furthermore, the above abnormalities were confirmed in patients with hypertension. The intestinal Bacteroides fragilis could inhibit the production of intestinal-derived corticosterone induced by high-salt diet through its metabolite arachidonic acid. CONCLUSIONS: hSIH could be transferred by fecal microbiota transplantation, indicating the pivotal roles of intestinal flora in hSIH development. High-salt diet reduced the levels of B fragilis and arachidonic acid in the intestine, which increased intestinal-derived corticosterone production and corticosterone levels in serum and intestine, thereby promoting BP elevation. This study revealed a novel mechanism different from inflammation/immunity by which intestinal flora regulated BP, namely intestinal flora could modulate BP by affecting steroid hormone levels. These findings enriched the understanding of the function of intestinal flora and its effects on hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Corticosterona/biossíntese , Microbioma Gastrointestinal/fisiologia , Hipertensão/fisiopatologia , Intestinos/química , Animais , Ácido Araquidônico/metabolismo , Bacteroides fragilis/fisiologia , Corticosterona/sangue , Transplante de Microbiota Fecal , Fezes/microbiologia , Humanos , Hipertensão/etiologia , Hipertensão/microbiologia , Intestinos/efeitos dos fármacos , Intestinos/microbiologia , Metabolômica/métodos , Ratos Wistar , Cloreto de Sódio na Dieta/efeitos adversos
11.
J Am Coll Cardiol ; 75(6): 632-647, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32057379

RESUMO

There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.


Assuntos
Hipertensão/prevenção & controle , Cloreto de Sódio na Dieta/efeitos adversos , Pressão Sanguínea , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Legislação sobre Alimentos
12.
Nat Med ; 26(3): 374-378, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32066973

RESUMO

Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (-2.17, -0.41)) in systolic and 0.76 mm Hg (95% CI (-1.39, -0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, -0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Características de Residência , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Estudos de Casos e Controles , Diástole , Feminino , Seguimentos , Humanos , Hipertensão/urina , Incidência , Masculino , Peru/epidemiologia , Potássio/urina , Sódio/urina , Inquéritos e Questionários , Sístole
13.
BMC Cardiovasc Disord ; 20(1): 98, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-32106813

RESUMO

BACKGROUND: Hypertension (HTN) is a ubiquitous risk factor for numerous non-communicable diseases, including cardiovascular disease and stroke. There are currently no wholly effective pharmacological therapies for subjects with HTN. However, salt substitutes have emerged as a potential therapy for the treatment of HTN. The aim of the present study was to assess the effect of salt substitutes on reducing systolic blood pressure (SBP) and diastolic BP (DBP), following a meta-analysis of randomized controlled trials. METHODS: Studies were found via systematic searches of the Pubmed/Medline, Scopus, Ovid, Google Scholar and Cochrane library. Ten studies, comprised of 11 trials and 1119 participants, were included in the meta-analysis. RESULTS: Pooled weighted mean differences showed significant reductions of SBP (WMD - 8.87 mmHg; 95% CI - 11.19, - 6.55, p < 0.001) and DBP (WMD - 4.04 mmHg; 95% CI - 5.70, - 2.39) with no statistically significant heterogeneity between the 11 included comparisons of SBPs and DBPs. The stratified analysis of trials based on the mean age of participants showed a significant reduction in the mean difference of SBP in both adults (< 65 years old) and elderly (≥65 years old). However, the DBP-lowering effect of salt substitutes was only observed in adult patients (WMD - 4.22 mmHg; 95% CI - 7.85, - 0.58), but not in the elderly subjects. CONCLUSIONS: These findings suggest that salt-substitution strategies could be used for lowering SBP and DBP in patients with stage 2 HTN; providing a nutritional platform for the treatment, amelioration, and prevention of HTN.


Assuntos
Pressão Sanguínea , Dieta Saudável , Dieta Hipossódica , Hipertensão/dietoterapia , Comportamento de Redução do Risco , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Resultado do Tratamento
14.
Sci Rep ; 10(1): 133, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924817

RESUMO

Circulating cells have a pathogenic role in the development of hypertensive nephropathy. However, how these cells infiltrate into the kidney are not fully elucidated. In this study, we investigated the role of CXCR6 in deoxycorticosterone acetate (DOCA)/salt-induced inflammation and fibrosis of the kidney. Following uninephrectomy, wild-type and CXCR6 knockout mice were treated with DOCA/salt for 3 weeks. Blood pressure was similar between wild-type and CXCR6 knockout mice at baseline and after treatment with DOCA/salt. Wild-type mice develop significant kidney injury, proteinuria, and kidney fibrosis after three weeks of DOCA/salt treatment. CXCR6 deficiency ameliorated kidney injury, proteinuria, and kidney fibrosis following treatment with DOCA/salt. Moreover, CXCR6 deficiency inhibited accumulation of bone marrow-derived fibroblasts and myofibroblasts in the kidney following treatment with DOCA/salt. Furthermore, CXCR6 deficiency markedly reduced the number of macrophages and T cells in the kidney after DOCA/salt treatment. In summary, our results identify a critical role of CXCR6 in the development of inflammation and fibrosis of the kidney in salt-sensitive hypertension.


Assuntos
Acetato de Desoxicorticosterona/efeitos adversos , Hipertensão/induzido quimicamente , Hipertensão/metabolismo , Rim/patologia , Receptores CXCR6/deficiência , Receptores CXCR6/genética , Cloreto de Sódio na Dieta/efeitos adversos , Animais , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/genética , Proteínas da Matriz Extracelular/metabolismo , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Fibrose , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/genética , Técnicas de Inativação de Genes , Hipertensão/genética , Hipertensão/patologia , Rim/efeitos dos fármacos , Rim/lesões , Rim/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Camundongos , Cloreto de Sódio na Dieta/administração & dosagem
15.
Nutr Rev ; 78(8): 688-698, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31995192

RESUMO

CONTEXT: Evidence has shown that essential nutrients are highly correlated with the occurrence of esophageal cancer (EC). However, findings from observational studies on the associations between dietary carbohydrate, salt consumption, and the risk of EC remain controversial. OBJECTIVE: The aim of this study was to conduct a systematic review and meta-analysis to confirm the associations of dietary carbohydrate and salt consumption with EC risk. DATA SOURCE: Various electronic databases (PubMed, MEDLINE, Embase, Google Scholar, Cochrane Library, Chinese Electronic Periodical Services, and China Knowledge Resource Integrated) were searched up until January 31, 2019. DATA EXTRACTION: Data related to patient characteristics and study characteristics were extracted by 2 independent reviewers. The risk ratio reported as relative risk (RR) or odds ratio (OR) was extracted, and random-effects models were performed to estimate the summary risk ratio. RESULTS: In total, 26 studies were included in this analysis, of which 12 studies, including 11 case-control studies and 1 cohort study, examined dietary carbohydrates, and 18 studies, including 16 case-control studies and 2 cohort studies, examined dietary salt. The pooled OR showed that dietary carbohydrate intake was inversely related to EC risk (OR = 0.62; 95% confidence interval [CI], 0.50-0.77), but positive correlations between dietary salt intake and the risk of EC were supported by the recruited case-control studies (OR = 1.97; 95% CI, 1.50-2.61) and cohort studies (RR = 1.04; 95% CI, 1.00-1.08). CONCLUSIONS: Salt is an essential nutrient for body functions and biochemical processes. Providing health education and management regarding proper use of salt in daily foods and labeling the amount of sodium in manufactured products to reduce the risk of developing EC should be more appropriately performed in the general population.


Assuntos
Neoplasias Esofágicas/etiologia , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Carboidratos da Dieta/efeitos adversos , Neoplasias Esofágicas/induzido quimicamente , Neoplasias Esofágicas/epidemiologia , Feminino , Humanos , Masculino , Estudos Observacionais como Assunto , Razão de Chances , Fatores de Risco
16.
Nutrients ; 12(2)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31973152

RESUMO

BACKGROUND AND AIM: Excess sodium intake is a recognised causal factor of hypertension and its cardiovascular complications; there is however a lack of practical instruments to assess and monitor the level of knowledge and behaviour about dietary salt intake and to relate these factors to the population general dietary habits. METHODS AND RESULTS: A self-administered questionnaire was developed to assess the salt and health related knowledge and behaviour of the Italian population through an online survey. A sample of 11,618 Italian participants completed the questionnaire. The degree of knowledge and the reported behaviour about salt intake were both found to be related to age, gender, home region, level of education and occupation. There was a significant interrelation between salt knowledge and behaviour and both were significantly and directly related to the degree of adherence to a Mediterranean-like dietary pattern. A hierarchical evaluation was also made of the relevance of any single question to the overall assessment of knowledge and behaviour about salt intake. CONCLUSIONS: The study population overall appeared to have a decent level of knowledge about salt, but a less satisfactory behaviour. Our findings point to social inequalities and young age as the main factors having a negative impact on knowledge and behaviour about salt intake as part of generally inadequate dietary habits. The degrees of knowledge and behaviour were significantly and directly interrelated, confirming that improving knowledge is a key step for behavioural changes, and suggesting that educational campaigns are crucial for the implementation of good practices in nutrition.


Assuntos
Dieta Saudável/psicologia , Comportamento Alimentar/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Cloreto de Sódio na Dieta/efeitos adversos , Adolescente , Adulto , Idoso , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Nutrients ; 12(2)2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31979147

RESUMO

Diets high in gelatinized starch and high in gelatinized starch supplemented with salt-induced metabolic disorders and changes in gut microbiota have scarcely been studied. In this study, mice on wheat starch diets (WD) exhibited significantly higher body weight, white adipose tissue (WAT), and gut permeability compared to those on normal diet (ND). However, gelatinized wheat starch diet (GWD) and NaCl-supplemented gelatinized wheat starch diet (SGW) mice did not increase body and WAT weights or dyslipidemia, and maintained consistent colon pH at ND levels. WD mice showed higher levels of Desulfovibrio, Faecalibaculum, and Lactobacillus and lower levels of Muribaculum compared to ND mice. However, GWD and SGW mice showed a significantly different gut microbial composition, such as a lower proportion of Lactobacillus and Desulfovibrio, and higher proportion of Faecalibaculum and Muribaculum compared to WD mice. High starch diet-induced dysbiosis caused increase of lipid accumulation and inflammation-related proteins' expression, thereby leading to non-alcoholic fatty liver disease. However, GWD and SGW showed lower levels than that, and it might be due to the difference in the gut microbial composition compared to WD. Taken together, diets high in gelatinized starch and high in gelatinized starch supplemented with salt induced mild metabolic disorders compared to native starch.


Assuntos
Dieta/efeitos adversos , Microbioma Gastrointestinal/efeitos dos fármacos , Doenças Metabólicas/etiologia , Cloreto de Sódio na Dieta/efeitos adversos , Amido/efeitos adversos , Triticum/química , Animais , Dieta/métodos , Disbiose/etiologia , Gelatina , Inflamação , Camundongos , Hepatopatia Gordurosa não Alcoólica/etiologia
18.
J Agric Food Chem ; 68(6): 1750-1759, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-31971384

RESUMO

Alcohol is a globally well-established cause of fatty liver disease (FLD). Increased salt consumption is associated with an increased prevalence of adipocyte hypertrophy and liver injury. In this study, high dietary salt potentiated chronic alcohol-induced hepatic damage. We explored the physiological mechanism of alcoholic FLD in the gastrointestinal tract. Male C57BL/6J mice (8-week-old) were fed a high-salt diet (HSD; 4% NaCl) with or without chronic ethanol (CE) for 1 month. The fecal microbiota, serum biochemical indices, intestinal permeability, level of liver damage, and liver mitochondria were evaluated. The HSD, CE, and their combination (HSDE) significantly changed the gut microbiota's structure, and the HSDE mice contained more probiotic species (e.g., Bifidobacterium and Lactobacillus). The serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels were increased, and the lipid was accumulated in the liver tissues in the CE, HSD, and HSDE groups, which indicated liver damage, especially in the HSDE group. The increased intestinal permeability and mitochondrial dysfunction in the liver cells caused greater injury in the HSDE group than in the other groups. Thus, consuming HSD with alcohol contributes to FLD development and progression.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Fígado Gorduroso Alcoólico/microbiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Cloreto de Sódio na Dieta/metabolismo , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Etanol/efeitos adversos , Etanol/metabolismo , Fígado Gorduroso Alcoólico/etiologia , Fígado Gorduroso Alcoólico/metabolismo , Fezes/microbiologia , Trato Gastrointestinal/metabolismo , Trato Gastrointestinal/microbiologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Cloreto de Sódio na Dieta/efeitos adversos
19.
Mymensingh Med J ; 29(1): 162-168, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915353

RESUMO

Hypertension and diabetes co-exist frequently. Therefore, salt intake behavior, a risk factor of hypertension, in diabetic patients plays an important role in determining their cardiovascular outcome. The purpose of this study was to assess the knowledge and behaviors of health risks associated with a salt intake in adults with type 2 diabetes. This cross-sectional study was conducted among the type 2 diabetic in-patients of Bangladesh Institute of Health Sciences General Hospital, Dhaka, Bangladesh from October to December 2016. Data were collected from 131 respondents through interview using WHO STEPS module of salt with adaptation to local context like on amount of added salt while taking meal. Information on blood pressure, body mass index and relevant co-morbidities were also collected. About half of the respondents were women (56.5%). Mean age of the respondents was 54.3±14.4 years. More than six in 10 of them (62.6%) took added salt while taking meal; and 40.5% took processed foods with high salt. The mean amount of added salt intake among the users was 4.4±1.6gm per day having no significant difference between men and women. Though 47.3% of the respondents believed that lowering salt in meal is very important and 77.9% of them believed that excess salt or salty sauce can cause health problems. Salt intake behavior is poor in patients with type 2 diabetes even having regular contacts with doctors and other health professionals. Appropriate measures can be taken to increase awareness, change their attitude and behavior regarding salt consumption.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Idoso , Bangladesh/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cloreto de Sódio na Dieta/administração & dosagem
20.
Public Health Nutr ; 23(8): 1450-1459, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31928552

RESUMO

OBJECTIVE: Globally, China is among the 'saltiest' nations. In order to support current nationwide salt reduction initiatives, we investigated Chinese consumers' knowledge, beliefs and behaviours related to salt intake and salt reduction. DESIGN: A cross-sectional face-to-face survey was carried out, focusing on salt knowledge, beliefs and behaviours related to salt intake and salt reduction, perceptions of salt reduction responsibility and support for different national strategies. SETTING: The survey was carried out in China mainland. PARTICIPANTS: Consumers (n 2444) from six of seven major geographical regions in China participated in the survey. After data cleaning, a sample of 2430 was included in the final analysis. RESULTS: A majority of Chinese consumers believed that salt added during home cooking was the biggest contributor to their salt intake. Knowledge gaps existed in the awareness of salt hidden in certain foods and flavouring products. Chinese consumers in general were interested in lowering their salt intake. They were aware of salt reduction tools, but the adoption level was low. Consumers expressed strong support for promotion of salt-restriction spoons and public education, but not fiscal policies (e.g. salt-related tax or subsidies). In terms of individual differences, education status demonstrated a substantial impact on salt reduction knowledge and behaviour. CONCLUSIONS: There is still big room to 'shake' Chinese consumers' salt habit. The present study provides important evidence and consumer insights to support China's efforts to meet its salt reduction targets.


Assuntos
Comportamento Alimentar , Conhecimentos, Atitudes e Prática em Saúde , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Idoso , China , Comportamento do Consumidor , Estudos Transversais , Dieta Hipossódica , Feminino , Rotulagem de Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Cloreto de Sódio na Dieta/efeitos adversos , Inquéritos e Questionários , Adulto Jovem
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